The exercise bronchoprovocation test: Standardization of procedures and evaluation of response

Cropp, Gerd J. A.

doi:10.1016/0091-6749(79)90026-5

Cited by 76 publications

(28 citation statements)

References 7 publications

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“…Previous laboratory studies on the incidence of this phenomenon in children produced inconsistent results, probably due to uncontrolled climatic factors (3,23,24,29,36). This has limited the practical usefulness of even standardized exercise bronchoprovocation (12,36) for the assessment of airway hyperreactivity in children (29). In the present study all 23, randomly selected, patients of a pediatric asthma clinic demonstrated a reaction to cold air hyperventilation which exceeded that of healthy control subjects.…”

Section: Resultsmentioning

confidence: 99%

Cold Air Challenge of Airway Hyperreactivity in Children: Practical Application and Theoretical Aspects

et al. 1984

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Section: Resultsmentioning

confidence: 99%

Cold Air Challenge of Airway Hyperreactivity in Children: Practical Application and Theoretical Aspects

et al. 1984

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“…Airway hyperresponsiveness: Provocative concentration of methacholine causing a 20% decline in FEV 1 (PC 20 ) less than or equal to 8 mg/ml (16) or greater than or equal to 10% reduction in FEV 1 following exercise challenge (17,(19)(20)(21).…”

Section: Variables Usedmentioning

confidence: 99%

Challenges in Identifying Asthma Subgroups Using Unsupervised Statistical Learning Techniques

Prosperi

Şahiner

Belgrave

et al. 2013

Am J Respir Crit Care Med

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Rationale: Unsupervised statistical learning techniques, such as exploratory factor analysis (EFA) and hierarchical clustering (HC), have been used to identify asthma phenotypes, with partly consistent results. Some of the inconsistency is caused by the variable selection and demographic and clinical differences among study populations. Objectives: To investigate the effects of the choice of statistical method and different preparations of data on the clustering results; and to relate these to disease severity. Methods: Several variants of EFA and HC were applied and compared using various sets of variables and different encodings and transformations within a dataset of 383 children with asthma. Variables included lung function, inflammatory and allergy markers, family history, environmental exposures, and medications. Clusters and original variables were related to asthma severity (logistic regression and Bayesian network analysis). Measurements and Main Results: EFA identified five components (eigenvalues > 1) explaining 35% of the overall variance. Variations of the HC (as linkage-distance functions) did not affect the cluster inference; however, using different variable encodings and transformations did. The derived clusters predicted asthma severity less than the original variables. Prognostic factors of severity were medication usage, current symptoms, lung function, paternal asthma, body mass index, and age of asthma onset. Bayesian networks indicated conditional dependence among variables. Conclusions: The use of different unsupervised statistical learning methods and different variable sets and encodings can lead to multiple and inconsistent subgroupings of asthma, not necessarily correlated with severity. The search for asthma phenotypes needs more careful selection of markers, consistent across different study populations, and more cautious interpretation of results from unsupervised learning.

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“…PEFR was widely used in past studies investigating airway response to exercise challenges (15,20), but have fallen out of favor due to high within-subject variability (21,22). We found a significant portion of the pulmonary function changes after exercise were within PEFR only.…”

Section: Discussionmentioning

confidence: 63%

Vigorous Exercise Can Cause Abnormal Pulmonary Function in Healthy Adolescents

Abosaida¹,

Chen²,

Nussbaum³

et al. 2015

Annals ATS

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Rationale: Although exercise-induced bronchoconstriction is more common in adolescents with asthma, it also manifests in healthy individuals without asthma. The steady-state exercise protocol is widely used and recommended by the American Thoracic Society (ATS) as a method to diagnose exercise-induced bronchoconstriction. Airway narrowing in response to exercise is thought to be related to airway wall dehydration secondary to hyperventilation. More rigorous exercise protocols may have a role in detecting exercise-induced bronchoconstriction in those who otherwise have a normal response to steady-state exercise challenge.Objectives: The objective of this study was to determine the effect of two different exercise protocols-a constant work rate protocol and a progressive ramp protocol-on pulmonary function testing in healthy adolescents. We hypothesized that vigorous exercise protocols would lead to reductions in lung function in healthy adolescents.Methods: A total of 56 healthy adolescents (mean age, 15.2 6 3.3 [SD] years) were recruited to perform two exercise protocols: constant work rate exercise test to evaluate for exercise-induced bronchoconstriction (as defined by ATS) and standardized progressive ramp protocol. Pulmonary function abnormalities were defined as a decline from baseline in FEV 1 of greater than 10%.Measurements and Main Results: Ten participants (17.8%) had a significant drop in FEV 1 . Among those with abnormal lung function after exercise, three (30%) were after the ATS test only, five (50%) were after the ramp test only, and two (20%) were after both ATS and ramp tests.Conclusion: Healthy adolescents demonstrate subtle bronchoconstriction after exercise. This exercise-induced bronchoconstriction may be detected in healthy adolescents via constant work rate or the progressive ramp protocol. In a clinical setting, ramp testing warrants consideration in adolescents suspected of having exercise-induced bronchoconstriction and who have normal responses to steady-state exercise testing.

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The exercise bronchoprovocation test: Standardization of procedures and evaluation of response

Cited by 76 publications

References 7 publications

Cold Air Challenge of Airway Hyperreactivity in Children: Practical Application and Theoretical Aspects

Cold Air Challenge of Airway Hyperreactivity in Children: Practical Application and Theoretical Aspects

Challenges in Identifying Asthma Subgroups Using Unsupervised Statistical Learning Techniques

Vigorous Exercise Can Cause Abnormal Pulmonary Function in Healthy Adolescents

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